Zuckerman E, Lanir A, Sabo E, Rosenvald-Zuckerman T, Matter I, Yeshurun D, Eldar S
Department of Medicine A, Institute of Pathology, Bnai Zion Medical Center, Haifa, Israel.
Am J Gastroenterol. 1999 Jun;94(6):1613-8. doi: 10.1111/j.1572-0241.1999.01152.x.
Cancer antigen 125 (CA 125) is a high molecular mass glycoprotein, usually used for monitoring the course of epithelial ovarian cancer. Recently it has been shown that liver cirrhosis is associated with increased levels of CA 125, particularly in the presence of ascites. The aim of this study was to evaluate CA 125 as a marker for the detection of ascites in patients with chronic liver disease.
A total of 170 patients were studied. All had ultrasound scanning for detection of ascites. Group I consisted of 123 patients with chronic liver disease without ascites; whereas group II consisted of 47 patients with chronic liver disease with ascites. CA 125 levels were measured in all patients and also simultaneously in the ascitic fluid of 31 patients from group II.
Of 47 patients, 46 (97.8%) of group II had elevated serum levels of CA 125 (mean 321 +/- 283 U/ml) as compared with only nine of 123 (7.3%) patients of group I [mean 13 +/- 15 U/ml]), p < 0.001. The mean CA 125 concentration in the ascitic fluid of 31 cirrhotic patients (group II) was 624 +/- 397 U/ml and was always higher than corresponding serum levels (p < 0.01). Serum CA 125 levels correlated with the amount of ascitic fluid (r = 0.78). A profound decrease in serum CA 125 concentration was noted 2-3 and 10 days after large volume paracentesis. CA 125 was more sensitive and preceded ultrasonography in detection of ascites in few cirrhotic patients.
CA 125 is a highly sensitive marker to detect ascites in patients with liver cirrhosis. This marker may be useful to detect small to moderate amounts of ascitic fluid in cirrhotic patients when physical examination is difficult or equivocal for ascites.
癌抗原125（CA 125）是一种高分子量糖蛋白，通常用于监测上皮性卵巢癌的病程。最近有研究表明，肝硬化与CA 125水平升高有关，尤其是在存在腹水的情况下。本研究的目的是评估CA 125作为慢性肝病患者腹水检测标志物的价值。
共研究了170例患者。所有患者均接受超声扫描以检测腹水。第一组由123例无腹水的慢性肝病患者组成；而第二组由47例有腹水的慢性肝病患者组成。对所有患者测定CA 125水平，并同时对第二组的31例患者的腹水进行CA 125水平测定。
47例第二组患者中，46例（97.8%）血清CA 125水平升高（平均321±283 U/ml），而第一组123例患者中只有9例（7.3%）升高（平均13±15 U/ml），p<0.001。31例肝硬化患者（第二组）腹水中CA 125的平均浓度为624±397 U/ml，且总是高于相应的血清水平（p<0.01）。血清CA 125水平与腹水量相关（r=0.78）。大量腹腔穿刺放液后2 - 3天和10天，血清CA 125浓度显著下降。在少数肝硬化患者中，CA 125在检测腹水方面比超声检查更敏感且更早出现阳性结果。
CA 125是检测肝硬化患者腹水的高敏标志物。当体格检查难以判断或难以明确是否存在腹水时，该标志物可能有助于检测肝硬化患者少量至中等量的腹水。
